Why Does Fioricet Work for Headaches?

What causes headaches?

Doctors don’t fully understand what causes most headaches. They do know that the brain tissue and the skull are never responsible since they don’t have nerves that register pain. But the blood vessels in the head and neck can signal pain, as can the tissues that surround the brain and some major nerves that originate in the brain. The scalp, sinuses, teeth, and muscles and joints of the neck can also cause head pain.

When Fioricet enters the brain, it acts similarly to several other CNS depressants (e.g., alcohol, benzodiazepines) by enhancing the activity of a neurotransmitter called gamma-aminobutyric acid (GABA).  GABA inhibits or slows certain processes in the brain and creates a relaxed feeling.  For this reason, doctors frequently prescribe CNS depressants for their ability to promote sleep and reduce anxiety.

How Does Fioricet Work ?

  • Fioricet is a combination pain-reliever (analgesic) containing acetaminophen, butalbital, and caffeine.
  • Experts aren’t sure exactly how acetaminophen works, but suspect it blocks a specific type of cyclo-oxygenase (COX) enzyme, located mainly in the brain.
  • Butalbital belongs to the class of medicines called barbiturates. When used for pain due to tension headaches experts believe it works by relaxing muscle contractions and causing sedation via an enhancement of the inhibitory effects of GABA (a neurotransmitter that regulates communication between brain cells).
  • Caffeine is thought to enhance the pain-relieving effects of acetaminophen by up to 40%. In addition, it has vasoconstrictive properties, narrowing blood vessels in the brain thereby decreasing blood flow and oxygen tension (before a headache or a migraine, blood vessels tend to enlarge). This also helps to relieve pain.
  • Fioricet belongs to the class of medicines known as barbiturates because it contains butalbital. It may also be called a combination analgesic.

When to worry about a headache

You can take care of many types of headaches by yourself, and your doctor can give you medication to control most of the tougher headaches. But some headaches call for prompt medical care. Here are some warning signs for when you should worry about headaches:

  • Headaches that first develop after age 50
  • A major change in the pattern of your headaches
  • An unusually severe headache
  • Head pain that increases with coughing or movement
  • Headaches that get steadily worse
  • Changes in personality or mental function
  • Headaches that are accompanied by fever, stiff neck, confusion, decreased alertness or memory, or neurological symptoms such as visual disturbances, slurred speech, weakness, numbness, or seizures
  • Headaches that are accompanied by a painful red eye
  • Headaches that are accompanied by pain and tenderness near the temples
  • Headaches after a blow to the head
  • Headaches that prevent normal daily activities
  • Headaches that come on abruptly, especially if they wake you up
  • Headaches in patients with cancer or impaired immune systems

Types of headaches

There are more than 300 types of headaches, but only about 10% of headaches have a known cause. The others are called primary headaches. Here is a rundown on some major primary headaches.

Tension headaches

Occurring in about three of every four adults, tension headaches are the most common of all headaches. In most cases, they are mild to moderate in severity and occur infrequently. But a few people get severe tension headaches, and some are troubled by them for three or four times a week.

The typical tension headache produces a dull, squeezing pain on both sides of the head. People with strong tension headaches may feel like their head is in a vise. The shoulders and neck can also ache. Some tension headaches are triggered by fatigue, emotional stress, or problems involving the muscles or joints of the neck or jaw. Most last for 20 minutes to two hours.

If you get occasional tension-type headaches, you can take care of them yourself. Over-the-counter pain relievers such as acetaminophen (Tylenol, other brands) and nonsteroidal anti-inflammatories (NSAIDs) such as aspirin, naproxen (Aleve, other brands), or ibuprofen (Motrin, Advil, other brands) often do the trick, but follow the directions on the label, and never take more than you should. A heating pad or warm shower may help; some people feel better with a short nap or light snack.

If you get frequent tension-type headaches, try to identify triggers so you can avoid them. Don’t get overtired or skip meals. Learn relaxation techniques; yoga is particularly helpful because it can relax both your mind and your neck muscles. If you clench your jaw or grind your teeth at night, a bite plate may help.

If you need more help, your doctor may prescribe a stronger pain medication or a muscle relaxant to control headache pain. Many people with recurrent tension-type headaches can prevent attacks by taking a tricyclic antidepressant such as amitriptyline (Elavil, generic). Fortunately, most people with tension-type headaches will do very well with simpler programs.

Migraine

Migraines occur less often than tension headaches, but they are usually much more severe. They are two to three times more common in women than men, but that’s small consolation if you are among the 6% to 8% of all men who have migraines. And since a Harvard study of 20,084 men age 40 to 84 reported that having migraines boosts the risk of heart attacks by 42%, men with migraines should take their headaches to heart.

Neurologists believe that migraines are caused by changes in the brain’s blood flow and nerve cell activity. Genetics play a role since 70% of migraine victims have at least one close relative with the problem.

Migraine triggers. Although a migraine can come on without warning, it is often set off by a trigger. The things that set off a migraine vary from person to person, but a migraine sufferer usually remains sensitive to the same triggers. The table lists some of the most common ones.

Major migraine triggers

      • Changing weather: rising humidity, heat
      • Lack of sleep or oversleeping
      • Fatigue
      • Emotional stress
      • Sensory triggers: bright or flickering lights, loud noises, strong smells
      • Dietary triggers:
        • missing a meal
        • alcohol, especially red wine
        • chocolate
        • nitrates in cured meats and fish
        • aged cheese
        • an increase or decrease in caffeine
        • MSG (often present in Asian and prepared foods)

Migraine symptoms. Migraines often begin in the evening or during sleep. In some people, the attacks are preceded by several hours of fatigue, depression, and sluggishness or by irritability and restlessness. Because migraine symptoms vary widely, at least half of all migraine sufferers think they have sinus or tension headaches, not migraines.

About 20% of migraines begin with one or more neurological symptoms called an aura. Visual complaints are most common. They may include halos, sparkles or flashing lights, wavy lines, and even temporary loss of vision. The aura may also produce numbness or tingling on one side of the body, especially the face or hand. Some patients develop aura symptoms without getting headaches; they often think they are having a stroke, not a migraine.

The majority of migraines develop without an aura. In typical cases, the pain is on one side of the head, often beginning around the eye and temple before spreading to the back of the head. The pain is frequently severe and is described as throbbing or pulsating. Nausea is common, and many migraine patients have a watering eye, a running nose, or congestion. If these symptoms are prominent, they may lead to a misdiagnosis of sinus headaches.

Without effective treatment, migraine attacks usually last for four to 24 hours. When you’re suffering a migraine, even four hours is far too long — and that’s why early treatment for a migraine is so important.

Migraine treatment. If you spot a migraine in its very earliest stages, you may be able to control it with nonprescription pain relievers. Acetaminophen, aspirin, ibuprofen, naproxen, and a combination of pain medications and caffeine are all effective — if you take a full dose very early in the attack. The anti-nausea drug metoclopramide (Reglan) may enhance the activity of NSAIDs.

When prescription drugs are needed, most doctors turn to the triptans, which are available as tablets, nasal sprays, or as injections that patients can learn to give to themselves. Examples include sumatriptan (Imitrex), zolmitriptan (Zomig), and rizatriptan (Maxalt). Triptans provide complete relief within two hours for up to 70% of patients; the response is best if treatment is started early. Some patients require a second dose within 12 to 24 hours. Because the triptans can affect blood flow to the heart as well as the head, patients with cardiovascular disease should not use them. Patients who take antidepressants in the SSRI family should also avoid triptans.

Work with your doctor to find the migraine treatment that works best for you. Remember, though, that overuse can lead to rebound headaches and a vicious cycle of drugs and headaches. So, if you need treatment more than two or three times a week, consider preventive medications.

Migraine prevention. Some people can prevent migraines simply by avoiding triggers. Others do well with prompt therapy for occasional attacks. But patients who suffer frequent migraine attacks often benefit from preventive medications. Effective prescription drugs include beta blockers (such as propranolol, nadolol and atenolol), certain antidepressants (such as amitriptyline), and certain antiseizure medications (such topiramate and valproate). Difficult cases may benefit from referral to a headache specialist.

Fioricet is a medication that is being used more and more often for patients who are struggling with constant tension All kinds of Headache and migraines.

Since these types of All kinds of Headache have similar causes, they can easily be treated with the same type of medication. Before you start using this medication, though, you might be wondering exactly how and why it works on your body. Here’s some information on the main ingredients in Fioricet and what they do for your body.

Fioricet contains a combination of acetaminophen, butalbital, and caffeine. Acetaminophen is a pain reliever and fever reducer. Butalbital is in a group of drugs called barbiturates. It relaxes muscle contractions involved in a tension headache.

Caffeine is a central nervous system stimulant. It relaxes muscle contractions in blood vessels to improve blood flow.

fioricet Mechanism of action
fioricet Mechanism of action

Fioricet is used to treat tension headaches that are caused by muscle contractions.

Butalbital has generalized depressant effect on central nervous system and, in very high doses, has peripheral effects.

Butalbital Mechanism of Action
Butalbital Mechanism of Action

 

the mechanism of action of acetaminophen
the mechanism of action of acetaminophen

Acetaminophen has analgesic and antipyretic effects mediated by a metabolite which acts at cannabinoid receptors, contrary to popular belief it is not an anti-inflammatory at safe levels (it becomes toxic at doses above 1,000mg per dose and/or 3,000mg per day).

caffeine mechanism of action
caffeine mechanism of action

Caffeine is thought to produce constriction of cerebral blood vessels and serves to counteract the sedative effect of butalbital.

Butalbital has a half-life of about 35 hours. Acetaminophen has a half-life of about 1.25 to 3 hours, but may be increased by liver damage and after an overdose. Caffeine has a half-life of about 5 to 7 hours. Butalbital is a barbiturate that slows certain central nervous system (CNS) processes via its interaction with brain receptors for the inhibitory neurotransmitter GABA.

Acetaminophen is one of the main ingredients in this medication. It is a blood thinner that is often used as an over the counter pain reliever and fever reducer. Chances are likely that if you’ve struggled with All kinds of Headache for a while, you may have already tried taking acetaminophen under different brand names to reduce your pain. Chances are likely that it didn’t work for the worst of your All kinds of Headache. The reason that it works in Fioricet, though, is that it’s combined with two other ingredients: Butalbital and caffeine.

Butalbital is a barbiturate, a powerful medication used to relax the muscles and ease tension. This medication can make some people sleepy, so you should be careful about using Fioricet when you’re driving or operating heavy machinery. Many times tension All kinds of Headache and migraines are caused by the tension in neck and shoulder muscles. Since Butalbital helps ease this tension, it can get rid of one of the underlying causes for such All kinds of Headache.

Many people are surprised to learn that caffeine is a major active ingredient in Fioricet. This substance, though, actually can increase blood flow and help the nervous system function more smoothly. For this reason, it helps the body loosen up and can also ensure that the other two active ingredients are delivered to the proper spots in the body more quickly through the fast-flowing blood stream.

Before you purchase Fioricet from a pharmacy, you might want to check out the different options for ordering this effective headache and tension medication.

You can actually get better prices by purchasing it online. Plus, ordering them online is excellent because you can conveniently get your medications delivered right to your door. The discretion and ease involved in purchasing your pain relieving medication this way is unparalleled by what any regular pharmacy can offer. Before you decide to purchase your Fioricet, make sure you research other purchasing options that might save you time and money.

 

What is Fioricet Interaction with other Drugs and Foods

Drug interactions can change the effects of how the medication works for you or increase the risk of unwanted side effects. Maintain a list of all other products you use apart from Fioricet.

Fioricet Interaction
Fioricet Interaction

These products can be non prescription or prescription drugs, herbal supplements etc., and share the list with your pharmacist or doctor. Do not try to stop, change the dosage or start any of the medicines without consulting your doctor.

Some products that can interact with Fioricet comprise of

  1. Oxybate
  2. Sodium
  3. Darunavir
  4. Drugs that affect liver enzymes and flush out the medication from the body like macrolide antibiotics such as valproic acid, rasagiline,cimetedine, disulfiram, erythromycin MAO inhibitors, fluvoxamine, methylene blue, phenelzine moclobemide, ), isoniazid, procarbazine, selegiline, phenothiazines, tranylcypromine, lithium etc.,

Fioricet accelerates the elimination of other drugs from the body by affecting some liver enzymes. These drugs that are affected include, blood thinners like estrogen, doxycycline, felodipine, theophylline etc.,

Also let your doctor know about any other drowsiness causing drugs that you are using like anti-seizure drugs or antihistamines or medicines for anxiety or sleeping disorders, muscle relaxants, psychiatric medicines  or narcotic pain relievers.

Check the labels before you buy any medicines for yourself even for cough or cold because they may contain caffeine or other components that cause drowsiness. Remember some beverages also contain caffeine like colas, coffee, tea and energy drinks. Consult your pharmacist to know how you can use these products safely.

Fioricet can also reduce the potency of birth control hormonal pills, ring or patch. This can lead to pregnancy. Consult your pharmacist or doctor if you should use other birth control options while using this medicine. Also let your doctor know if you experience breakthrough bleeding or new spotting as this can be the indication that your birth control technique is not functioning properly.

Fioricet can also interfere with certain laboratory or medical tests, resulting in giving incorrect test results. Make sure your doctor or laboratory personnel know that you are using this drug.

Alcohol and Fioricet

Check with your doctor regarding alcohol consumption while taking Fioricet. The medicine might increase the intoxication effects of alcohol. Drinking when you are on Fioricet may result in liver damage due to acetaminophen.

It is very important to know about the drug interaction with all other medications you are using including supplements and simple medications used for cold and cough. Knowing about the contents of medications you are using, you can easily know about the risk linked to drug interactions. You can also let your doctor know about the other medications you are using so that your doctor helps you know Fioricet interactions with those medicines.

You can avoid the risks linked to drug interactions and in case you experience any unusual symptoms, you can connect with your doctor. Though Fioricet is quite useful, it comes with a lot of restrictions too, you just need to take care of those limitations to get better results. Try to get maximum benefits from your drug.

FIORICET Lifestyle Interactions

Butalbital 50mg, Acetaminophen 300mg, Caffeine 40mg, Oral capsule

Tobacco

· Severity: Moderate

· Notes for Consumers: If you are a tobacco smoker, use of Acetaminophen can increase the risk of liver side effects. Immediately tell your doctor if you get severe abdominal pain, nausea, vomiting, or yellowing of the skin. Do not exceed 4 g acetaminophen/day in adults. Tell your doctor if Acetaminophen does not help your headache or other pain. Tobacco smoke may reduce the effectiveness of Acetaminophen.

· Notes for Professionals: Tobacco smoking induces the cytochrome P450 isoenzyme CYP1A2 and may potentially increase the risk for acetaminophen-induced hepatotoxicity during overdose via enhanced generation of acetaminophen’s hepatotoxic metabolite, NAPQI. In one study, current tobacco smoking was found to be very frequent in patients admitted with acetaminophen poisoning. Tobacco smoking appears to be an independent risk factor of severe hepatotoxicity, acute liver failure and death following acetaminophen overdose.

Butalbital 50mg, Acetaminophen 300mg, Caffeine 40mg, Oral capsule

Grapefruit juice

· Severity: Mild

· Notes for Consumers: Do not significantly alter your grapefruit juice intake while taking medicines containing caffeine. Some reports suggest that intake of grapefruit juice can increase side effects from caffeine. Too much Caffeine can cause effects like nausea, tremor, nervousness, or sleeplessness. If these occur, consider ingesting less caffeine daily.

· Notes for Professionals: Data are limited and conflicting as to whether grapefruit juice significantly alters the serum concentrations and/or AUC of caffeine. Caffeine is primarily a CYP1A2 substrate, and grapefruit juice appears to have but a small effect on this enzyme in vivo. One report suggests that grapefruit juice decreases caffeine elimination by inhibition of flavin-containing monooxygenase, a P450 independent system. This interaction might increase caffeine levels and mildly potentiate the clinical effects and common side effects of caffeine. If side effects appear, patients may need to limit either caffeine or grapefruit juice intake.

Butalbital 50mg, Acetaminophen 300mg, Caffeine 40mg, Oral capsule

Caffeine-containing Foods/Beverages

· Severity: Moderate

· Notes for Consumers: Caffeine may cause sleeplessness, so if you are taking a Barbiturate to help you sleep, you may wish to avoid taking caffeine and caffeine-containing foods like colas, coffee, teas, or chocolates within several hours prior to bedtime. Barbiturates may also decrease the actions of Caffeine; if you have a high intake of caffeinated foods or beverages you may experience a headache or irritability from decreased caffeine levels while taking these drugs until your body adjusts. If you take Caffeine for other purposes, notify your health care provider if you think Caffeine is not working as well for you.

· Notes for Professionals: Caffeine has been reported to increase the metabolism of barbiturates, and barbiturates increase caffeine elimination. Higher caffeine doses may be needed after barbiturate administration.

Butalbital 50mg, Acetaminophen 300mg, Caffeine 40mg, Oral capsule

Marijuana

· Severity: Moderate

· Notes for Consumers: The effects of marijuana may be decreased if combined with this medicine. Do not drive or operate machinery until you know how this combination will affect you. Contact your health care provider right away if you notice slurred speech, confusion, severe drowsiness, increased heart rate, or any other new or unusual side effects.

· Notes for Professionals: The incidence of marijuana associated adverse effects may change following coadministration with barbiturates. Barbiturates are inducers of CYP2C9 and CYP3A4, two isoenzymes responsible for the metabolism of marijuana’s most psychoactive compound, delta-9-tetrahydrocannabinol (Delta-9-THC). When given concurrently with barbiturates, the amount of Delta-9-THC converted to the active metabolite 11-hydroxy-delta-9-tetrahydrocannabinol (11-OH-THC) may be increased. These changes in Delta-9-THC and 11-OH-THC plasma concentrations may result in an altered marijuana adverse event profile.

Butalbital 50mg, Acetaminophen 300mg, Caffeine 40mg, Oral capsule

Alcohol

· Severity: Major

· Notes for Consumers: Avoid alcohol-containing drinks while taking this medicine. Using this drug along with alcohol can lead to serious side effects. You may feel drowsy or more tired when taking these drugs together. Do not drive or operate machinery until you know how this drug affects you, and especially if you are drinking alcohol-containing beverages. If you notice slurred speech, confusion, severe weakness, or difficulty breathing, contact your health care provider immediately.

· Notes for Professionals: Alcohol is associated with CNS depression. The combined use of alcohol and CNS depressants can lead to additive CNS depression, which could be dangerous in tasks requiring mental alertness and fatal in overdose. Alcohol taken with other CNS depressants can lead to additive respiratory depression, hypotension, profound sedation, or coma. Consider the patient’s use of alcohol or illicit drugs when prescribing CNS depressant medications. In many cases, the patient should receive a lower dose of the CNS depressant initially if the patient is not likely to be compliant with avoiding alcohol.

Butalbital 50mg, Acetaminophen 300mg, Caffeine 40mg, Oral capsule

Tobacco

· Severity: Moderate

· Notes for Consumers: Tobacco smoke contains substances that may speed the removal of Caffeine from the body. If you start smoking Caffeine may become less effective. Tobacco smokers often drink several caffeinated beverages daily. Just the opposite occurs when someone stops smoking tobacco; if you stop smoking this may increase the amount of Caffeine in the blood and side effects from Caffeine may get worse. Too much Caffeine can cause nausea, nervousness, or sleeplessness, and occasionally other effects like tremor. If you stop smoking tobacco, you may need to lower your Caffeine intake.

· Notes for Professionals: Inducers of the hepatic CYP450 isoenzyme CYP1A2 may induce the hepatic oxidative metabolism of caffeine. Tobacco smoke contains hydrocarbons that induce hepatic CYP450 microsomal enzymes (e.g., CYP1A1, CYP1A2, CYP2E1). The increased clearance of caffeine by smokers may contribute to the higher consumption of caffeinated beverages reported to occur in this group. Because the effect on hepatic microsomal enzymes is not related to the nicotine component of tobacco, the sudden cessation of tobacco smoking may result in a reduced clearance of caffeine, despite the initiation of a nicotine replacement product. Following several days of abstinence from chronic tobacco smoking, caffeine clearance may decrease by roughly 40%, leading to the possible occurrence of caffeine-related side effects like nausea, nervousness, irritability, tremors, or insomnia, if caffeine use remains the same.

Butalbital 50mg, Acetaminophen 300mg, Caffeine 40mg, Oral capsule

Caffeine-containing Foods/Beverages

· Severity: Moderate

· Notes for Consumers: While taking Caffeine-containing medicines, limit the use of foods, beverages (examples: coffee, tea, colas), herbs (examples: guarana, green tea) and other products that contain additional caffeine, such as chocolate and some non-prescription medications or dietary supplements for headache, insomnia, or weight loss. Too much Caffeine can cause effects like nausea, nervousness, or sleeplessness. Some drug products for adults that contain caffeine have about as much caffeine as a cup of coffee.

· Notes for Professionals: Certain foods that contain high amounts of caffeine or theobromine should be limited during the therapeutic use of caffeine in order to limit additive methylxanthine effects. While taking Caffeine-containing medicines, limit the use of foods, beverages (examples: coffee, tea, colas), herbs (examples: guarana, green tea) and other products that contain additional caffeine, such as chocolate and some non-prescription medications or dietary supplements for headache, insomnia, or weight loss. Too much Caffeine can cause effects like nausea, nervousness, or sleeplessness. Some drug products for adults that contain caffeine have about as much caffeine as a cup of coffee.

Butalbital 50mg, Acetaminophen 300mg, Caffeine 40mg, Oral capsule

Alcohol

· Severity: Major

· Notes for Consumers: Patients who drink more than 3 alcoholic drinks a day and take Acetaminophen are at increased risk of developing liver side effects. Limit alcohol intake while taking Acetaminophen. Avoid alcoholic drinks if you are taking Acetaminophen on a regular basis.

· Notes for Professionals: The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume ethanol. Patients who drink more than 3 alcoholic drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic ethanol use increases acetaminophen-induced hepatotoxicity by inducing cytochrome P450 CYP 2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume ethanol regularly.

FIORICET Interact with other Medications?

Severe Interactions

These medications are not usually taken together. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation.

  • SEDATIVE HYPNOTICS; ALCOHOL/SODIUM OXYBATE
  • XANTHINE DERIVATIVES/DIPYRIDAMOLE INJECTABLE

Serious Interactions

These medications may interact and cause very harmful effects. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation.

  • THEOPHYLLINE DERIVATIVES/CIMETIDINE
  • SELECTED ANTICONVULSANTS; BARBITURATES/CONTRACEPTIVES
  • SELECTED CYP1A2 SUBSTRATES/VILOXAZINE
  • STRONG CYP3A4 INDUCERS/ARIPIPRAZOLE LAUROXIL SUBMICRONIZED
  • SELECTED BARBITURATES/SELECTED ANTICONVULSANTS
  • SELECTED BARBITURATES/LAMOTRIGINE
  • SELECTED BARBITURATES/ESLICARBAZEPINE
  • SELECTED BARBITURATES/CARBAMAZEPINE
  • STRONG CYP3A4 INDUCERS/TRABECTEDIN
  • STRONG CYP3A4 INDUCERS/FLIBANSERIN
  • STRONG CYP3A4 INDUCERS/QUETIAPINE (> 150 MG)
  • STRONG CYP3A4 INDUCERS/TOLVAPTAN
  • STRONG CYP3A4 INDUCERS/SELECTED IMMUNOSUPPRESSANTS
  • ACETAMINOPHEN/SODIUM FUSIDATE
  • XANTHINE DERIVATIVES/ADENOSINE; HEXOBENDINE; REGADENOSON
  • BARBITURATES/METHOXYFLURANE
  • STR 3A4 INDUCER;SLT BARBITURATES,HYDANTOIN/SLT ANTIMALARIALS
  • BARBITURATES/SELECTED ANTICOAGULANTS (VIT K ANTAGONISTS)

Moderate Interactions

These medications may cause some risk when taken together. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation.

  • THEOPHYLLINE DERIVATIVES/LITHIUM
  • SELECTED ANTICONVULSANTS/ESTROGENS
  • SELECTED XANTHINE DERIVATIVES/FLUVOXAMINE
  • ACETAMINOPHEN/ISONIAZID
  • BARBITURATES/PHENOTHIAZINES
  • BARBITURATES/HALOPERIDOL
  • BARBITURATES/RIFAMPIN
  • ACETAMINOPHEN/BUSULFAN
  • ACETAMINOPHEN/SELECTED ANTICOAGULANTS
  • STRONG CYP3A4 INDUCERS/SELECTED ANTIPSYCHOTICS
  • SELECTED ANTICONVULSANTS/FELODIPINE
  • BARBITURATES/METRONIDAZOLE
  • BARBITURATES; HYDANTOINS/THEOPHYLLINE
  • CYP3A4 INDUCERS/DOXYCYCLINE
  • SELECTED CYP3A4 INDUCERS/CORTICOSTEROIDS
  • BARBITURATES/SELECTED BETA-BLOCKERS

Fioricet Drug Interactions that You Should Know

Fioricet Manufacture List

Fioricet and Esgic are brand names of a combination of butalbital (a barbiturate), acetaminophen and caffeine which is indicated for the treatment of tension headaches, muscle contraction headaches and post-dural puncture headaches.

Although not indicated, they are commonly used to treat migraines and other painrelated ailments. Fioricet is indicated for the treatment of muscle tension or muscle contraction headaches. It is also commonly prescribed for migraines although it is not FDA indicated for this use in the United States. The usual adult dose is 1-2 tablets every four hours as needed, not exceeding six tablets in a 24-hour period.

There are a lot of manufacturers can produce generic fioricet because they are just compound of butalbital, apap, caffeine. What we can find the fioricet manufacturers are as following:

watsonfioricet2

Watson Fioricet. Manufactured By: Nexgen Pharma, INC – NDC:0591-2640-01

cardinalhealth

Cardinal Health NDC 55254-2073-0

mikartfioricet3

Mikart, INC NDC 46672-059-10

westwardfioricet2

West-Ward Fioricet, West-Ward Pharmaceutical Corp. NDC 0143-1115-01

 

gsmsfioricet

GSMS Incorporated Fioricet NDC 60426-252-01

lanettfioricet

Lannett Company INC Fioricet  NDC 0527-1695-01

annett Company INC Fioricet  NDC 0527-1695-01

libertasfioricet

Libertas Pharma INC. Fioricet NDC 51862-179-01

 

mirrorfioricet

Mirror Pharmaceuticals Fioricet NDC 52682-041-03

nexgenfioricet

Nexgen Pharma Fioricet NDC 0722-7029-01

physicianfioricet

Qualitest Pharmaceuticals Fioricet  NDC 42254-323-60

 

qualitest

Qualitest Fioricet NDC 0603-2544-21

Actually There are much more Generic Fioricet manufacturers there. We cannot list them all.  All legal Fioricet manufacturers have NDC number. Normally a pharmacy can not guarantee what brand fioricet generic they will distribute.

Different customers have different experience on taking Fioricet brand.

Some think watson fioricet is better, some think Mikart Fioricet is better, some think Oblong Fioricet is hard to take. But a lot of patient likes Mikart more.

 

Medication Overuse Headache

A medication-overuse headache (MOH), once known as a rebound headache, drug-induced headache, or medication-misuse headache, is a chronic headache that develops as a result of prolonged and frequent use of certain medications for acute headaches. Such headaches are a common side effect of a number of classes of medications used to treat headaches.

According to the International Classification of Headache Disorders, MOH is diagnosed when a person has a headache 15 or more times a day and, in the case of combination pain relievers like Fioricet and Fiorinal, has been taking the drug for 10 days a month for more than three months.

In addition, medication overuse headaches are often not responsive to preventive headache medications. This lack of response to other medications is often a clue to doctors that a medication overuse headache has developed.

Medications containing butalbital should be limited to two days per week to avoid this rebound effect.7

What is a Fioricet High? Can Fioricet Cause Abuse ?

Fioricet is a prescription medication used to manage frequent or uncontrolled tension headaches.  Fioricet may be helpful for someone struggling with tension headaches (although evidence supporting its effectiveness for recurring headaches is lacking); however, it must be used cautiously.

You can not be addictive to Fioricet but you can depend on it.

Fioricet is a known drug of abuse that has the potential to bring about serious physical and mental health complications. Anyone who is unable to control their Fioricet use should consider substance abuse treatment. By consulting with an addiction professional or attending substance abuse treatment, a person can quit Fioricet safely and learn to address the thoughts and behaviors that keep them using in spite of the harm that doing so causes.

One of the key active ingredients responsible for the so-called Fioricet high is butalbital.

Butalbital is a barbiturate that’s considered short-to-intermediate acting, and it can relieve symptoms of anxiety, reduce pain, relax muscles and act as a sedative. There are many neuropsychological effects of butalbital, some of which aren’t clearly understood to this day.

The belief is that the Fioricet high is caused by the fact that butalbital can increase the inhibition neurotransmitters in the brain called GABA. It can bind to certain receptor sites and ultimately central nervous system activity is depressed. This can lead to what feels like a buzz or to some people possibly a high.

So what does a Fioricet high feel like?

This article is not good. Fioricet can not be addictive because you will be die if you abuse fioircet.

For the most part, it’s likely to feel similar to other central nervous system depressant effects. There is some evidence pointing to the fact that taking Fioricet can feel similar to the effects of drinking alcohol, particularly when the prescription drug is taken at higher levels.

The following are some of the common experiences that people say come along with a Fioricet high:

  • Fioricet can reduce anxiety and some people with anxiety disorders may take it for this reason, although this is not what it’s approved for. There is the potential for Fioricet to decrease feelings of anxiety even when it’s taken at a normal dose, and this is because of the impact of butalbital on GABA. For some people, a Fioricet high is actually just equated with a reduction in anxiety.
  • Depersonalization may be another effect of the so-called Fioricet high, although this isn’t necessarily something people find pleasant. It can lead to feelings of confusion and sluggishness, and this is one of the reasons Fioricet isn’t frequently used
  • Drowsiness and sedation may also be side effects of a Fioricet high, particularly when it’s taken in larger amounts. While Fioricet has a stimulant component which is caffeine when larger doses are taken the central nervous system depressant effects may override the stimulant effects.
  • Some people may obtain a sense of euphoria when taking Fioricet, although it’s not as pronounced as what would occur with something like prescription opioids. As with most other drugs, if someone does experience euphoria with a Fioricet high, it’s likely to dissipate after using the drug a few times as they build a tolerance.
  • While not everyone who takes Fioricet says they experience euphoria, some people say that it does improve their mood. This can be because of the GABA-related effects of butalbital, but also the inclusion of the acetaminophen and the caffeine. There’s also the element of stimulation that can occur with caffeine, so some people may feel this is a Fioricet high when they experience it.
  • Lightheadedness and dizziness are common side effects of Fioricet, and these may also be symptoms that people associate with a Fioricet high.
  • One of the primary reasons people will abuse Fioricet and take high doses is to achieve relaxation, which occurs because of the slowdown of the central nervous system. People who take this drug may feel relaxed and also tranquil. Some of this is because of the loosening up of muscles the drug can stimulate.

Not everyone will associate the use of this drug with the Fioricet high. Some of the factors that determine whether or not a person will experience a Fioricet high can include the dosage they take and their tolerance. Newer users may be more likely to experience what they would describe as the Fioricet high. Other factors that could influence this include the specific formulation of the drug and whether or not other substances are taken with it.

Some people may try to extract the butalbital from Fioricet and remove it from the caffeine and acetaminophen for a greater high. This is not only drug abuse, but might not even achieve the effects the person is looking for.

It’s important to realize that there can be serious and deadly consequences associated with trying to achieve a Fioricet high. This can include addiction, adverse reactions, brain damage, emotional crashes, and overdose. Since Fioricet has acetaminophen, if people abuse it to get high they may also sustain liver damage or failure.

What Are the Withdrawal Symptoms?

Chronic excessive use of Fioricet may result in the development of significant physiological dependence. The unpleasant withdrawal syndrome that arises when a dependent person tries to quit can inhibit them from seeking the help they need to get off the drug. Symptoms can range from mild to very serious.

Fioricet withdrawal often begins with headaches, which people may see as a common headache instead of a withdrawal symptom. Unknowingly, they may use more Fioricet to manage the headache and restart the cycle of abuse.7 Someone who makes it past the initial headache stage of Fioricet withdrawal may have additional symptoms like:

  • Hand tremors.
  • Fast or jerky movements.
  • Anxiety.
  • Rapid pulse.
  • Hallucinations.
  • Nausea/vomiting.
  • Grand mal seizures.

Severe butalbital withdrawal symptoms may begin about 16 hours after the last dose.1 The symptoms will then peak on the second day and will typically show a noteworthy improvement by day 5 and then gradually improve over the course of about 2 weeks.1

Seeking professional treatment for Fioricet withdrawal is crucial, not only because it will alleviate your discomfort to prevent you from relapsing, but also because withdrawal from this drug is associated with sometimes-lethal complications. As many as 30% of those who attempt withdrawal from drugs like Fioricet without treatment will experience a seizure.6

Additionally, withdrawal can spark intense depression, leading to suicidal thoughts and attempts. Depression may be worse among people stuck in patterns of frequent intoxication and repeated withdrawal attempts.

 

How Fioricet Is Supplied and The all kinds of Fioricet Pictures and Manufacturers

Esgic® Capsules, containing butalbital 50 mg (WARNING: May be habit-forming), acetaminophen 325 mg and caffeine 40 mg, are opaque white, body and cap, and are imprinted with logo on one side and “535- 12” in kelly green ink. They are supplied in bottles of 100 capsules, NDC 0535-0012-01.

Storage

Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].

Dispense in a tight, light-resistant container with a child-resistant closure.

Fioricet Images and Butalbital APAP Caffeine Manufacturers

The combination of acetaminophen, butalbital, and caffeine is called Generic fioricet and it is used to treat tension headaches that are caused by muscle contractions. It is also widely used for migraine, cluster headache and all kinds of headache even neck pain.

Butalbital, acetaminophen, and caffeine combination is used to relieve symptoms of tension (or muscle contraction) headaches.

Butalbital belongs to the group of medicines called barbiturates. Barbiturates act in the central nervous system (CNS) to produce their effects.

Acetaminophen is used to relieve pain and reduce fever in patients. It does not become habit-forming when taken for a long time. But acetaminophen may cause other unwanted effects when taken in large doses, including liver damage.

When butalbital is used for a long time, it may become habit-forming, causing mental or physical dependence. However, people who have continuing pain should not let the fear of dependence keep them from using narcotics to relieve their pain. Physical dependence may lead to withdrawal side effects if treatment is stopped suddenly. However, severe withdrawal side effects can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped completely.

Caffeine is a CNS stimulant that is used with pain relievers to increase their effect. It has also been used for migraine headaches. However, caffeine can also cause physical dependence when it is used for a long time. This may lead to withdrawal (rebound) headaches when you stop taking it.

Acetaminophen is a pain reliever and fever reducer. Butalbital is in a group of drugs called barbiturates. It relaxes muscle contractions involved in a tension headache. Caffeine is a central nervous system stimulant. It relaxes muscle contractions in blood vessels to improve blood flow.

The usual adult dose is 1-2 tablets every four hours as needed, not exceeding six tablets in a 24-hour period.

There are a lot of manufacturers can produce generic fioricet because they are just compound of butalbital, apap, caffeine.

Acetaminophen, butalbital, and caffeine may also be used for purposes not listed in this medication guide. The images of generic fioricet are listed below:

apap-butalb-caffeine325-50-40mgtab-mal

apap-butalbital-caffeine325-50-40mg-wat

apap-butalbital-caffeinecap-qua

apap-but-caff-qua

esgiccap

esgicplus

fioricet

fiorpap

Buy Cheap Fioricet to Get Your Work and Social Life Back in Order

If you suffer from chronic tension or migraine headaches, you know the effects these ailments can have on your work and social life. Many chronic headache sufferers lose pay due to lost work and have had to cancel social engagements because the pain is too great to function normally.

 

 

Buy Fioricet Online
Buy Fioricet Online

Butalbital/acetaminophen/caffeine is a combination product used for treating headache.

Fioricet is a prescription medication used to manage frequent or uncontrolled tension headaches.Fioricet may be helpful for someone struggling with tension headaches (although evidence supporting its effectiveness for recurring headaches is lacking); however, it must be used cautiously. Fioricet is a known drug of abuse that has the potential to bring about serious physical and mental health complications.1Anyone who is unable to control their Fioricet use should consider substance abuse treatment. By consulting with an addiction professional or attending substance abuse treatment, a person can quit Fioricet safely and learn to address the thoughts and behaviors that keep them using in spite of the harm that doing so causes.2

What is Fioricet and How to buy Fioricet Online ?

Butalbital is a narcotic that depresses the central nervous system. Acetaminophen is a pain reliever and fever reducer. It is the active compound in Tylenol. Acetaminophen relieves pain by elevating the pain threshold, that is, by requiring a greater amount of pain to develop before a person feels it. It reduces fever through its action on the heat-regulating center of the brain. Specifically, it tells the center to lower the body’s temperature when the temperature is elevated.

Caffeine has pain relieving properties and may boost the action of other pain relievers by mechanisms that are not well understood. It may reduce the activity of pain sensing nerves in the brain. The FDA approved butalbital/acetaminophen/caffeine in November 1984.

Patients taking combination drugs of butalbital, acetaminophen, and caffeine should review the patient safety information such as specific side effects, drug interactions, and pregnancy safety for each of these drugs.

Trying to alleviate headaches through the assortment of pain medications available may not have produced affective results. A consequence of this is that many people cope with pain on a regular basis. This can be an extremely frustrating and painful experience. Before giving up altogether, buy cheap Fioricet. It may provide you with a solution to your chronic headaches.

If you have dealt with tension or migraine headaches for some time, you are likely to have spent quite a bit of money and effort on over-the-counter medications that are not strong enough to alleviate severe headache pain. Fioricet is quite different from the numerous run-of-the-mill pain medications offered.

It contains the three active ingredients acetaminophen, butalbital, and caffeine. These key ingredients work together to produce a fast-working headache relief medium.

How do these ingredients work? Acetaminophen increases the body’s pain tolerance. Its effect is increased significantly when combined with caffeine and a barbiturate such as butalbital. Butalbital further inhibits tension, which relaxes the body.

When the muscles and blood vessels in the body are in their relaxed state, the mind tends to follow, which is an excellent state to be in when trying to reduce headache pressure. Caffeine works as a vasoconstrictor, and so reduces any increased blood vessel flow. It therefore decreases the chances of the nerves around blood vessels to become aggravated.

If you decide to buy cheap Fioricet, your best option may be to search online for a reputable medication dealer. Fioricet can be purchased legally once a prescription is obtained. Many doctors now work for online pharmacies and are able to provide a prescription through these pharmacies. Not only will you save money, but you will also skip the hassle of having to go into a clinic to get a prescription. In addition , when you buy Fioricet online, it will be delivered to your door.

Cheap Fioricet works just as well as more expensive versions of this medicine. All prescription medicine is held to the same standards. If you would like to save money by avoiding identical pricier medications, Fioricet may provide you with a fantastic solution.

Proper Use of Fioricet

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If butalbital and acetaminophen combination is taken regularly (for example, every day), it may become habit-forming (causing mental or physical dependence). The caffeine in some butalbital and acetaminophen combinations can also increase the chance of dependence. Dependence is especially likely to occur in patients who take these medicines to relieve frequent headaches. Taking too much of this medicine may also lead to liver damage or other medical problems.

This medicine will relieve a headache best if you take it as soon as the headache begins. If you get warning signs of a migraine, take this medicine as soon as you are sure that the migraine is coming. This may even stop the headache pain from occurring. Lying down in a quiet, dark room for a while after taking the medicine also helps to relieve headaches.

People who get a lot of headaches may need to take a different medicine to help prevent headaches. It is important that you follow your doctor’s directions about taking the other medicine, even if your headaches continue to occur. Headache-preventing medicines may take several weeks to start working. Even after they do start working, your headaches may not go away completely. However, your headaches should occur less often, and they should be less severe and easier to relieve than before. This will reduce the amount of headache relievers that you need. If you do not notice any improvement after several weeks of headache-preventing treatment, check with your doctor.

 

 

What Side Effects May I Notice From Receiving Butalbital APAP Caffeine ?

Side effects that you should report to your doctor or health care professional as soon as possible after you take Butalbital APAP Caffeine.

      • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
      • anxious
      • breathing problems
      • confusion
      • fast, irregular heartbeat
      • redness, blistering, peeling or loosening of the skin, including inside the mouth
      • seizures

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

    • constipation
    • dry mouth
    • nausea, vomiting
    • tiredness

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Butalbital APAP Caffeine Side Effects

Check with your doctor immediately if any of the following side effects occur:

Rare

  1. Bleeding or crusting sores on lips
  2. chest pain
  3. fever with or without chills
  4. hive-like swellings (large) on eyelids, face, lips, and/or tongue
  5. muscle cramps or pain
  6. red, thickened, or scaly skin
  7. shortness of breath, troubled breathing, tightness in chest, or wheezing
  8. skin rash, itching, or hives
  9. sores, ulcers, or white spots in mouth (painful)

Symptoms of overdose

  1. Anxiety, confusion, excitement, irritability, nervousness, restlessness, or trouble in sleeping (severe, especially with products containing caffeine)
  2. convulsions (seizures) (for products containing caffeine)
  3. diarrhea, especially if occurring together with increased sweating, loss of appetite, and stomach cramps or pain
  4. dizziness, lightheadedness, drowsiness, or weakness, (severe)
  5. frequent urination (for products containing caffeine)
  6. hallucinations (seeing, hearing, or feeling things that are not there)
  7. increased sensitivity to touch or pain (for products containing caffeine)
  8. muscle trembling or twitching (for products containing caffeine)
  9. nausea or vomiting, sometimes with blood
  10. ringing or other sounds in ears (for products containing caffeine)
  11. seeing flashes of “zig-zag” lights (for products containing caffeine)
  12. shortness of breath or unusually slow or troubled breathing
  13. slow, fast, or irregular heartbeat
  14. slurred speech
  15. staggering
  16. swelling, pain, or tenderness in the upper abdomen or stomach area
  17. unusual movements of the eyes

Check with your doctor as soon as possible if any of the following side effects occur:

Less common

  1. Confusion (mild)
  2. mental depression
  3. unusual excitement (mild)

Rare

  1. Bloody or black, tarry stools
  2. bloody urine
  3. pinpoint red spots on skin
  4. swollen or painful glands
  5. unusual bleeding or bruising
  6. unusual tiredness or weakness (mild

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  1. Bloated or “gassy” feeling
  2. dizziness or lightheadedness (mild)
  3. drowsiness (mild)
  4. nausea, vomiting, or stomach pain (occurring without other symptoms of overdose)

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

What are the Symptoms of a Fioricet Overdose?

While butalbital is the addictive ingredient in Fioricet, acetaminophen is the ingredient which is liable to cause an overdose. Unfortunately, people who misuse Fioricet as a recreational drug or as a way to suppress withdrawal are most likely to suffer an overdose.

When a person overdoses on Fioricet, the acetaminophen will damage their liver. In severe cases, an overdose can even provoke fatal liver failure. For this reason, it is dangerous to take Fioricet together with another medication which contains acetaminophen because it increases the risk of overdose and death. Furthermore, drinking alcohol while taking Fioricet may also inflict liver damage.

A Fioricet overdose is a medical emergency, so it’s important to know the symptoms. An overdose on Fioricet and all other forms of liver failure cause jaundice, the yellowing of the skin and eyes. Other symptoms of an overdose include:

  • Confusion
  • Convulsions and seizures
  • Fainting
  • Irregular heartbeat
  • Lack of appetite
  • Nausea and vomiting
  • Restlessness
  • Stomach pain
  • Sweating
  • Tremors

What is Butalbital APAP Caffeine ?

Butalbital, acetaminophen, and caffeine combination is used to relieve symptoms of tension (or muscle contraction) headaches.

Butalbital belongs to the group of medicines called barbiturates. Barbiturates act in the central nervous system (CNS) to produce their effects.

Acetaminophen is used to relieve pain and reduce fever in patients. It does not become habit-forming when taken for a long time. But acetaminophen may cause other unwanted effects when taken in large doses, including liver damage.

When butalbital is used for a long time, it may become habit-forming, causing mental or physical dependence. However, people who have continuing pain should not let the fear of dependence keep them from using narcotics to relieve their pain. Physical dependence may lead to withdrawal side effects if treatment is stopped suddenly. However, severe withdrawal side effects can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped completely.

Caffeine is a CNS stimulant that is used with pain relievers to increase their effect. It has also been used for migraine headaches. However, caffeine can also cause physical dependence when it is used for a long time. This may lead to withdrawal (rebound) headaches when you stop taking it.

This medicine is available only with your doctor’s prescription.

This product is available in the following dosage forms:

      • Tablet
      • Capsule
      • Solution

This combination medication is used to treat tension headaches. Aspirin helps to decrease the pain from the headache. Caffeine helps increase the effects of aspirin. Butalbital is a sedative that helps to decrease anxiety and cause sleepiness and relaxation.

How to use Butalbital-APAP-Caffeine Tablet

Take this medication by mouth, usually every 4 hours as needed or as directed by your doctor. Do not take more than 6 capsules/tablets in a 24-hour period. Take with a full glass of water (8 ounces or 240 milliliters) unless your doctor directs you otherwise. Do not lie down for at least 10 minutes after taking this medication. To help prevent stomach upset, take it with food or milk.

The dosage is based on your medical condition and response to therapy. This medication works best if it is used as the first signs of a headache occur. If you wait until the headache has worsened, the medication may not work as well.

If you suddenly stop using this medication, you may have withdrawal symptoms (such as nausea/vomiting, mental/mood changes, seizures). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used this medication for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.

Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Do not increase your dose, take it more often, or use it for a longer time than prescribed. Use the smallest effective dose. Properly stop the medication when so directed.

Side Effects of Butalbital APAP Caffeine

Nausea, vomiting, stomach upset, gas, shaking (tremor), lightheadedness, dizziness, or drowsiness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

To lower your risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: mental/mood changes, fainting, fast/irregular heartbeat, increased thirst/urination, hearing changes (e.g., ringing in the ears), easy bruising/bleeding, signs of infection (e.g., fever, persistent sore throat), heartburn, discomfort when swallowing, dark urine, yellowing eyes/skin, signs of kidney problems (such as change in the amount of urine), unusual tiredness.

Seek immediate medical attention if any of these rare but very serious side effects occur: black stools, severe stomach/abdominal pain, vomit that looks like coffee grounds, trouble speaking, weakness on one side of the body.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US –

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions of Butalbital APAP Caffeine

Before taking this medication, tell your doctor or pharmacist if you are allergic to aspirin, caffeine, or butalbital; or to other barbiturates (e.g., phenobarbital), salicylates (e.g., salsalate), nonsteroidal anti-inflammatory drugs (e.g., ibuprofen), or xanthine derivatives (e.g., theophylline); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: severe breathing problems (e.g., bronchopneumonia), a certain enzyme disorder (porphyria), aspirin-sensitive asthma (a history of worsening breathing with runny/stuffy nose after taking aspirin or other NSAIDs), severe stomach/bowel problems (e.g., stomach/intestinal ulcers), bleeding/blood clotting disorders (e.g., hemophilia, von Willebrand’s disease, thrombocytopenia).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, asthma, heartburn, gout, growths in the nose (nasal polyps), personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol), certain enzyme deficiencies (pyruvate kinase or G6-PD deficiency), mental/mood disorders, heart disease (e.g., irregular heartbeat, recent heart attack).

Before having surgery or certain medical procedures (such as a heart stress test or a procedure to restore a normal heart rhythm if you have an unusually fast heartbeat), tell your doctor or dentist that you use this medication and about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

This medicine may cause stomach bleeding. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.

This medication contains aspirin. Children and teenagers less than 18 years old should not take aspirin if they have chickenpox, flu, or any undiagnosed illness, or if they have just been given a live virus vaccine, without first consulting a doctor about Reye’s syndrome, a rare but serious illness.

Older adults may be more sensitive to the side effects of this drug, especially drowsiness, stomach/intestinal bleeding and ulcers, and trouble falling asleep. Drowsiness and trouble falling asleep can increase the risk of falling.

Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks. Tell your doctor if you are pregnant or if you plan to become pregnant. This medication may harm an unborn baby and cause problems with normal labor/delivery. It is not recommended for use in pregnancy from 20 weeks until delivery. If your doctor decides that you need to use this medication between 20 and 30 weeks of pregnancy, you should use the lowest effective dose for the shortest possible time. You should not use this medication after 30 weeks of pregnancy.

This drug passes into breast milk and could have undesirable effects on a nursing infant. Therefore, breast-feeding is not recommended while using this drug. Consult your doctor before breast-feeding.

Interactions of Butalbital APAP Caffeine

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include: darunavir, dichlorphenamide, ketorolac, mifepristone, sodium oxybate, acetazolamide, certain drugs used to treat gout (including uricosuric drugs such as probenecid, sulfinpyrazone), certain antibiotics (including penicillin, sulfonamides such as sulfamethoxazole), drugs affecting liver enzymes that remove this medication from your body (such as macrolide antibiotics including erythromycin, cimetidine, disulfiram, valproic acid, MAO inhibitors including isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine), lithium, 6-mercaptopurine, methotrexate, methoxyflurane, phenytoin.

This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, “blood thinners” such as dabigatran/enoxaparin/warfarin, among others.

This drug can speed up the removal of other drugs from your body by affecting certain liver enzymes. These affected drugs include corticosteroids such as prednisone, estrogen, felodipine, quinidine, certain beta blockers such as metoprolol, theophylline, doxycycline.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), other drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (allergy or cough-and-cold products, other headache medications) because they may contain aspirin, caffeine, or ingredients that cause drowsiness. Also keep in mind that certain beverages (e.g., coffee, colas, tea) contain caffeine. Ask your pharmacist about using those products safely.

Also, check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (NSAIDs such as ibuprofen, naproxen, aspirin) that may increase your risk for side effects if taken together with this medication. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually at dosages of 81-325 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

This medication may decrease the effectiveness of hormonal birth control such as pills, patch, or ring. This could cause pregnancy. Discuss with your doctor or pharmacist if you should use additional reliable birth control methods while using this medication. Also tell your doctor if you have any new spotting or breakthrough bleeding, because these may be signs that your birth control is not working well.

This medication may interfere with certain medical/laboratory tests (including fasting blood glucose, cholesterol levels, prothrombin time, urine 5-HIAA levels, urine VMA levels, certain urine glucose tests, dipyridamole-thallium imaging tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Overdose of Butalbital APAP Caffeine

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, slow breathing, severe dizziness, persistent nausea/vomiting, ringing in the ears.

Do not share this medication with others. Sharing it is against the law.

Massage, hot baths, and other relaxation methods can help with tension headaches. Consult your doctor or pharmacist for more details.

Laboratory and/or medical tests (e.g., liver and kidney function tests) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Missed Dose

Not applicable.

Storage Of Butalbital APAP Caffeine

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.